title: Methohexital in total intravenous anesthesia during intraoperative neurophysiological monitoring.
abstract: Total intravenous anesthesia (TIVA) is usually recommended during spinal surgery when transcranial motor evoked potentials (tcMEPs) are used to monitor. A shortage of propofol has prompted a search for an alternative sedative-hypnotic agent. We explored the use of methohexital as an alternative. TIVA was provided for two adult patients having spinal surgery using an infusion of methohexital. TcMEPs and somatosensory evoked potentials were acquired to monitor neurological function and electroencephalogram was used to titrate the methohexital dose. Two cases are presented in which the anesthesia and monitoring that was provided were successful. These cases indicate that methohexital can be a suitable alternative to propofol in some patients.
authors.affiliation: Department of Anesthesiology, University of Colorado Denver School of Medicine, Anschutz Office West (AO1), MS 8202, 12631 E 17th Avenue, Aurora, CO, 80045, USA, tod.sloan@ucdenver.edu.
authors.forename: Tod B
authors.initials: TB
authors.lastname: Sloan
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Vasquez
authors.forename: Evalina
authors.initials: E
authors.lastname: Burger
mesh_terms: D000328:Adult; D000368:Aged; D000771:Anesthesia, Intravenous / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D017586:Diskectomy; D004569:Electroencephalography; D019054:Evoked Potentials, Motor / Q000187:drug effects / Q000502:physiology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring / Q000379:methods*; D008723:Methohexital / Q000627:therapeutic use*; D008875:Middle Aged; D013123:Spinal Fusion; D013130:Spinal Stenosis / Q000601:surgery; D013131:Spine / Q000601:surgery
chemical_list: D018686:Anesthetics, Intravenous; D008723:Methohexital